Anxiety Disorders

Question 1

When does anxiety become pathological?

Answer 1

> When the response is out of proportion to stimulus (subjective, physical phenomena)
When response continues when stimulus is no longer there (excess duration)
When there becomes social or occupational impairment (destructive)
often comorbid with substance use and depression

Question 2

What kinds of specific phobias do you get?

Answer 2

Animal
Natural environment
Blood injection injury
Situational
Other

Question 3

What are the different types of anxiety disorders classified in the DSM?

Answer 3

Generalised anxiety disorder
Specific phobia (animal, environment, blood injection, situational, other)
Social anxiety disorder
Panic disorder
Agoraphobia
Anxiety due to substance/medication
Anxiety due to AMC
Unspecified anxiety

Question 4

DSM criteria for Generalized anxiety disorder

Answer 4

A: significant anxiety and worry on most days that not for 6 months about a number of events eg school or work
B: difficult to control worry
C: associated with at least 3 of (C-FIRST)
>concentration problems
>fatigue easily
>irritability
>restlessness
>sleep problems
>tension in muscles
D: anxiety causes significant distress or impairment in social, occupational functioning
E: sx not physiological process caused by substance or medication or AMC
F: not better explained by another mental disorder

Question 5

Define stress

Answer 5

Sum of all physiological and psychological responses to an event or situation that requires adjustment

Question 6

Define panic attack

Answer 6

A surge of intense fear or discomfort that peaks within minutes

Question 7

Associated symptoms in DSM for panic disorder

Answer 7

STUDENTS Fear the 3 C’s (need at least 4)

Sweating
Trembling
Unsteady/dizzy
Depersonalisation + Derealisation
Excessive heart rate + palpitations
Nausea
Tingling
Fear of going crazy, dying, losing control
3C’s = chest pain, chills, choking

Question 8

DSM criteria for Panic Disorder

Answer 8

A: recurrent panic attacks (surge of intense fear/discomfort that peaks within minutes) associated with at least 4 of: Sweating, Trembling, Unsteady/dizzy, Depersonalisation/Derealisation, Elevated HR + palpitations, Nausea, Tingling, Shortness of breath, Fear of going crazy/dying/losing control, Chest pain, Chills, Choking
B: >/= 1 month of anxiety of panic attacks with at least 1 of: 1) persistent worry about recurrent attacks and its consequences, 2) significant maladaptive behaviour related to the attacks
C: Not physiological process substance or AMC
D: not more likely caused by another mental illness

Question 9

DSM criteria for Phobic Disorder

Answer 9

A: exposure to stimulus almost invariably provokes sx of anxiety, may present as panic attack
B: patient aware that response is excessive/unreasonable
C: stimulus is avoided/ endured with discomfort and anxiety
D: significant impact on daily routine or occupational and social functioning
E: not better accounted for by another mental disorder, substances or AMC

Question 10

DSM for agoraphobia

Answer 10

A: marked fear/anxiety with at least 2/5
>fear open spaces
>fear closed spaces
>fear of lines/crowd
>fear being out of home alone
>using public transport
B: avoids these situations because of fear of difficulty escaping situation/developing embarrassing symptoms/not being able to get help
C: these situations almost always provoke fear
D: these situations are actively avoided, companion needed or endures with severe anxiety and fear
E: fear endured is out of proportion to situation.
F: fear/anxiety/avoidance lasts 6months at least
G: causes significant clinical distress/ social and occupational dysfunction
H: if AMC present, fear and anxiety is clearly excessive
I: fear and anxiety not better explained by another mental disorder, not caused by obsessions, perceived flaws in appearance, traumatic experience, or fear of separation